Information needed to get someone

started in Tupperware, right away!

Name: _____________________________________________________________________________

Social Security #: ___________________________________________________________________

Address: _________________________________City___________________State/Zip___________

Shipping address if different from above: _____________________________________________

Phone: (cell) ____________________________(other) _______________________________

Birthday (MM/DD/YYYY): ______________________________

Email: (H)_______________________________(W)___________________________________

English Kit: ___ Spanish Kit: ___

Which kit payment option?

____ $30 down + tax (Have $900 in sales within 60 days to have Tupperware pay off the

balance!)

____ $99 + tax (Have $900 in sales within 60 days to be reimbursed $69 as a credit on the

next $450 order!!)

Which card to be used: (circle one) Visa MasterCard Discover

Card #: ___________________________________________ Exp date: ____________

Name on card: __________________________________________________________

*Make sure that the billing address for this card is the same as above. If it isn’t – please add that!

________________________________________________________________________________

Street, City, State, Zip